Μνήμη Edward Livingston Trudeau

Στις 15 Νοεμβρίου 2015, συμπληρώνονται 100 χρόνια από το θάνατο του Έντουαρντ Λίβινγκστον Τρουντώ. Ο Δρ Τρουντώ ήταν πρωτεργάτης της δημιουργίας σανατορίων και ίδρυσε το πρώτο εργαστήριο για την αντιμετώπιση της φυματίωσης στις ΗΠΑ. Ακολουθεί σημείωμα από την ιστοσελίδα της Αμερικανικής Πνευμονολογικής Εταιρείας (http://news.thoracic.org/?p=7540)  

   

On Nov. 15, 2015, the world will mark the centennial of Edward Livingston Trudeau’s death. Dr. Trudeau launched the sanitarium movement in the U.S., established the country’s first tuberculosis laboratory, served as the first president of the organization that would become the American Lung Association, and helped found its medical division, now the American Thoracic Society.

Although the prevalence of TB and the care of those infected with the bacterium is vastly different from when Dr. Trudeau opened the Adirondack Cottage Sanitarium in Saranac Lake, New York, in 1882, Dr. Trudeau’s philosophy and approach to taking on the greatest killer in human history are still reflected in the work of the ATS.

Born in 1848, Edward Livingston Trudeau was a teenager when his brother James was diagnosed with tuberculosis. Young Edward cared for his brother for three months before he died. A few years later, Edward, himself, showed the first signs of having contracted the disease while studying at Columbia University’s College of Physicians and Surgeons.

At that time, TB was erroneously characterized as, in Dr. Trudeau’s words, “a non-contagious, generally incurable and inherited disease, due to inherited constitutional peculiarities, perverted humors and various types of inflammation.”

When Dr. Trudeau graduated, medical education was conducted almost exclusively in lecture halls, without patients and without microscopic studies. His career, however, would change our understanding of TB and help revolutionize medical education and research in the process.

By the time Dr. Trudeau was formally diagnosed with TB, he was a husband and recent father. The disease was so quickly debilitating that he abandoned his fledgling medical practice and traveled in the summer of 1873 to the Adirondack Mountains. If the fresh air and rest did not arrest his decline, he was prepared to die in a place he loved as a child.

Fortunately, his health did improve, and, a few years later, he moved his family permanently to Saranac Lake. There in 1884, he opened his sanitarium cottage, dubbed “The Little Red” because of its color and 250-square-foot size.

He was inspired by reports from two German physicians published in 1882. In the first, Robert Koch identified the bacterium that causes TB. In the second, Hermann Brehmer, described the success of the sanitarium he founded.

Dr. Trudeau would build on both men’s work. He outfitted a laboratory in his house to study TB and conducted rigorous experiments. This was the origin of what is now the Trudeau Institute, a biomedical research center in Saranac Lake.

In his most famous experiment, Dr. Trudeau infected 10 rabbits with mycobacterium tuberculosis. He exposed half the infected rabbits to inhospitable conditions—dank, tight quarters, with inadequate nutrition. The other five rabbits he turned loose on a small island with plenty of food. All five of the rabbits in the first group died while only one of the five infected rabbits who had the run of the island did. He also subjected five uninfected rabbits to the same harsh conditions as the five that had been infected. Though weakened, the five uninfected rabbits did not develop TB, proving the disease could not develop in the absence of the bacterium.

As the sanitarium grew, other physicians joined and conducted their own research. On his 60th birthday, these associates presented Dr. Trudeau with two bound volumes containing 70 scientific papers on tuberculosis they had published in U.S. and international journals.

From the beginning, Dr. Trudeau wanted his sanitarium to serve working-class patients. Dr. Trudeau did not charge for his services, and by soliciting friends he made among the wealthy businessmen who traveled to the Adirondacks to hunt, he was able to offer care for less than it cost. The Little Red’s first tenants were two sisters who had worked in factories. Eventually, the sanitarium had sufficient funds—its endowment was $600,000 in 1914—to offer free care to many.

Equally important, Dr. Trudeau recognized that residents needed to feel productive. In addition to being involved in the day-to-day tasks of the sanitarium, interested patients were taught bookbinding, leather work, woodcarving, and illuminating.

One of his greatest achievements was turning the sanitarium into an education center. In 1912, a nursing school for former patients who wanted to work with TB patients opened, and a year after his death, Dr. Trudeau’s vision for offering specialized training for physicians in TB care and research came to fruition with a six-week postgraduate program.

His career also underscored the importance of public health. “The sanitarium, research, education programs, and founding of the ALA and ATS, were all part of his aim of engaging the public in the issue of public health that have lasted beyond his lifetime,” says past president Dean Schraufnagel, MD, who is co-author along with Philip Hopewell and John Murray of an article on the history of treating TB that will be published in the November Annals of the American Thoracic Society.

By the time the Adirondack Cottage Sanitarium closed in 1954, less than a decade after the first effective antibiotic against TB became available, Saranac Lake had been home to more than 15,000 TB patients, most of whom did survive. Although Dr. Trudeau did not discover a cure for tuberculosis, he demonstrated how clinical care, research, and education can work together to thwart a formidable threat to public health. He also revealed the importance of hope to every patient.

“Trudeau’s great talent, I now understand, was for hope—a commodity in short supply during the worst years of the White Plague,” writes his great grandson, the cartoonist Garry Trudeau, in the foreword to Portrait of Healing, a book about Dr. Trudeau and his sanitarium. “People came to Saranac Lake to cure, not to die, and that was new”._